Abstract: A portable alarm transmitter for compliance monitoring detects whether a user is wearing the device. If not, a special alarm signal is sent to the monitoring service provider so that remedial actions can be taken. The alarm transmitter comprises a motion sensor, and an algorithm thereby for detecting whether the alarm device is being worn by the user. The alarm transmitter distinguish between non-compliance (e.g. user has taken off the alarm device) versus other “activities of daily living (ADL) that may appear to be non-compliance events (e.g. sleeping) by incorporating user stimulus and user response.